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Conditions That Mimic Stroke

Selim R. Benbadis, MD
Arch Neurol. 1996;53(5):404-404. doi:10.1001/archneur.1996.00550050026010
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The recent article by Libman et al1 has crucial implications for acute stroke management. For the clinician, knowing which conditions may mimic stroke is indeed very important information. However, knowing how these conditions may mimic stroke may be equally important. The inclusion criterion in their "Patients and Methods" section stated: "sudden onset of a focal deficit—either by history or on examination" is somewhat vague and perhaps overly inclusive. The focal deficits on the basis of which these conditions were misdiagnosed as strokes could have been prevented, especially for those conditions that would not be expected to cause focal symptoms or signs. This was the case for five of the top seven conditions listed (systemic infection, toxic-metabolic, cardiac, syncope, and vertigo). Daily experience suggests that patients and primary care physicians consider stroke a top diagnostic possibility (even in the presence of nonfocal symptoms) not because it is the most

REFERENCES

Libman RB, Wirkowski E, Alvir J, Rao TH.  Conditions that mimic stroke in the emergency department: implications for acute stroke trials . Arch Neurol . 1995;;52:1119-1122.
Heyman A, Leviton A, Millikan CH, et al.  Study group on TIA criteria and detection: transient focal cerebral ischemia: epidemiological and clinical aspects . Stroke . 1974;;5:277-284.
Benbadis SR, Sila CA, Cristea RL.  Mental status changes and stroke . J Gen Intern Med . 1994;;9:485-487.

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Libman RB, Wirkowski E, Alvir J, Rao TH.  Conditions that mimic stroke in the emergency department: implications for acute stroke trials . Arch Neurol . 1995;;52:1119-1122.
Heyman A, Leviton A, Millikan CH, et al.  Study group on TIA criteria and detection: transient focal cerebral ischemia: epidemiological and clinical aspects . Stroke . 1974;;5:277-284.
Benbadis SR, Sila CA, Cristea RL.  Mental status changes and stroke . J Gen Intern Med . 1994;;9:485-487.

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